| Name: | EAST SIDE PRESCRIPTION CENTER, INC. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Dissolved |
| Date of Organization in Rhode Island: | 14 Apr 1977 (48 years ago) |
| Date of Dissolution: | 11 Feb 2022 (3 years ago) |
| Date of Status Change: | 11 Feb 2022 (3 years ago) |
| Identification Number: | 000011290 |
| ZIP code: | 02906 |
| County: | Providence County |
| Principal Address: | 632 HOPE STREET, PROVIDENCE, RI, 02906, USA |
| Purpose: | DRUG STORE/LIQUOR |
| Fictitious names: |
East Side Wine and Spirits (trading name, 2016-04-28 - ) |
NAICS
445310 Beer, Wine, and Liquor StoresThis industry comprises establishments primarily engaged in retailing packaged alcoholic beverages, such as ale, beer, wine, and liquor. Learn more at the U.S. Census Bureau
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194760470 | 2006-06-19 | 2009-01-20 | 632 HOPE ST, PROVIDENCE, RI, 029062658, US | 632 HOPE ST, PROVIDENCE, RI, 029062658, US | |||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 401-751-1430 |
| Fax | 4014548096 |
Authorized person
| Name | MR. RICHARD E BACKER |
| Role | PRES |
| Phone | 4017511430 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | ES04467 |
| State | RI |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 209 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | ES04467 |
| State | RI |
| Issuer | NCPDP |
| Number | 4102961 |
| Issuer | MEDICAID |
| Number | 9010209 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| SYDNEY I. RESNICK, ESQ. | Agent | 20 EAST BEL AIR ROAD, CRANSTON, RI, 02920, USA |
| Name | Role | Address |
|---|---|---|
| RICHARD BACKER | PRESIDENT | 40 HULING LANE EAST GREENWICH, RI 02818 USA |
| Name | Role | Address |
|---|---|---|
| CHARLOTTE BACKER | VICE PRESIDENT | 40 HULING LANE EAST GREENWICH, RI 02818 USA |
| Number | Name | File Date |
|---|---|---|
| 202210722950 | Articles of Dissolution | 2022-02-11 |
| 202210722310 | Annual Report | 2022-02-11 |
| 202210721980 | Reinstatement | 2022-02-11 |
| 202199623390 | Revocation Certificate For Failure to File the Annual Report for the Year | 2021-07-29 |
| 202196726760 | Revocation Notice For Failure to File An Annual Report | 2021-05-19 |
| 202031415000 | Annual Report | 2020-01-08 |
| 201984473420 | Annual Report | 2019-01-15 |
| 201861565170 | Annual Report | 2018-04-04 |
| 201730796430 | Annual Report | 2017-01-25 |
| 201696296630 | Annual Report | 2016-04-28 |
Date of last update: 06 Apr 2025
Sources: Rhode Island Department of State
